RateTrack Annuity Contract Internal Exchange Statement and Agreement

Fixed Annuity

RateTrack Annuity Contract Internal Exchange Statement and Agreement

Use this form to transfer funds internally from an existing RateTrack® contract to another contract/account. This form and accompanying application can be submitted within 30 days of contract anniversary. Forms submitted before 30 days of contract anniversary will be considered not in good order.

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Instructions
  1. Complete each section of this form prior to the time that a transfer of assets is requested. This agreement will prevent you from being in “constructive receipt” of the amount transferred.
  2. Complete and submit a Security Benefit application and any applicable state-required replacement forms.

Once all required paperwork is received, Security Benefit will establish a new contract/account and will process the withdrawal from the current contract. The valuation date will be determined as of the date all paperwork is received in good order.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
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For questions or assistance, please call 800.888.2461.